Modern approaches to the therapy of genital herpes in women

Literature review

Authors

DOI:

https://doi.org/10.18370/2309-4117.2023.68.94-98

Keywords:

genital herpes, treatment, Virostat

Abstract

Genital herpes (GH) is a common sexually transmitted disease caused by the herpes simplex virus (HSV). It is characterized by lifelong infection and periodic reactivation. Until recently, GH was more often caused by HSV type 2 (HSV-2), but now it very common infection cases by HSV type 1 (HSV-1) and in some countries are even more common than HSV-2. More than 400 million people currently have GH caused by HSV-2 in the world. In the United States nearly one in five adults (approximately 40 million people) are infected with HSV-2. About 1 million new infections occur every year.
Recently, much attention has been paid to the issue of new approaches to GH therapy in women. The problem is extremely urgent, since this infection is very common in the world. The main causes of GH are HSV-1 and HSV-2.
Approaches to the treatment of GH differ depending on the type of virus (HSV-1 or HSV-2), as well as the absence or presence of clinical manifestations. The analysis of literature data shows that is there are two ways of GH treatment: episodic antiviral therapy, when patients undergo short courses of antiviral therapy during GH relapse, or suppressive antiviral therapy, when patients take medication daily to prevent relapses.
Our clinical experience allows us to recommend the ukrainian drug Virostat (manufacturer “Kyiv Vitamin Plant”) for the treatment of HSV infection in women. The scheme of treatment with the Virostat depends on whether these are the first manifestations of infection or its recurrence.
There are no approved vaccines for the treatment and prevention of GH, therefore, active prevention and early diagnosis increase the chances of safe and effective treatment of GH in women of different age groups and at different stages of the disease.

Author Biographies

L.B. Markin, Danylo Halytsky Lviv National Medical University, Lviv

MD, professor, corresponding member of the NAMS of Ukraine, head of the Obstetrics and Gynecology Department

O.O. Matviіenko, Danylo Halytsky Lviv National Medical University, Lviv

PhD, associate professor, Obstetrics and Gynecology Department

O.O. Korytko, Danylo Halytsky Lviv National Medical University, Lviv

PhD, associate professor, Obstetrics and Gynecology Department

K.L. Shatylovych, Danylo Halytsky Lviv National Medical University, Lviv

MD, professor, Obstetrics and Gynecology Department

References

  1. Aggerholm, B.S., Ostenfeld, E.B., Andersen, L.H.J., et al. “Genital herpes simplex virus infection in pregnancy.” Ugeskr Laeger 182.5 (2020): V09190527. Available from: [https://ugeskriftet.dk/videnskab/herpes-genitalis-under-graviditet-og-fodsel].
  2. Anselem, O. “Management of pregnant women with recurrent herpes. Guidelines for clinical practice from the French College of Gynecologists, Obstetricians (CNGOF).” Gynecol Obstet Fertil Senol 45.12 (2017): 677–90. DOI: 10.1016/j.gofs.2017.10.003. Available from: [https://www.sciencedirect.com/science/article/abs/pii/S2468718917302349?via%3Dihub].
  3. Awasthi, S., Friedman, H.M. “Status of prophylactic and therapeutic genital herpes vaccines.” Curr Opin Virol 6 (2014): 6–12. DOI: 10.1016/j.coviro.2014.02.006. Available from: [https://www.sciencedirect.com/science/article/abs/pii/S187962571400039X?via%3Dihub].
  4. Awasthi, S., Shaw, C., Friedman, H. “Improving immunogenicity and efficacy of vaccines for genital herpes containing herpes simplex virus glycoprotein D.” Expert Rev Vaccines 13.12 (2014): 1475–88. DOI: 10.1586/14760584.2014.951336. Available from:[https://www.tandfonline.com/doi/abs/1 0.1586/14760584.2014.951336?journalCode=ierv20].
  5. Bender Ignacio, R.A., Perti, T., Magaret, A.S., et al. “Oral and Vaginal Tenofovir for Genital Herpes Simplex Virus Type 2 Shedding in Immunocompetent Women: A Double-Blind, Randomized, Cross-over Trial.” J Infect Dis 212.12 (2015): 1949–56. DOI: 10.1093/infdis/jiv317. Available from: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655855/].
  6. Chatroux, I.C., Hersh, A.R., Caughey, A.B. “Herpes Simplex Virus Serotyping in Pregnant Women With a History of Genital Herpes and an Outbreak in the Third Trimester of Pregnancy: A Cost-Effectiveness Analysis.” Obstet Gynecol 137.1 (2021): 63–71. DOI: 10.1097/AOG.0000000000004181. Available from: [https://journals.lww.com/greenjournal/Abstract/2021/01000/Herpes_Simplex_Virus_ Serotyping_in_Pregnant_Women.9.aspx].
  7. Cole, S. “Herpes Simplex Virus: Epidemiology, Diagnosis, and Treatment.” Nurs Clin North Am 55.3 (2020): 337–45. DOI: 10.1016/j.cnur.2020.05.004. Available from: [https://pubmed.ncbi.nlm.nih.gov/32762854].
  8. Dalton, A., Grivell, R. “Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks’ Gestation.” Case Rep Obstet Gynecol 2015 (2015): 198547. DOI: 10.1155/2015/198547. Available from: [https://www.hindawi.com/journals/criog/2015/198547/].
  9. Durukan, D., Fairley, C.K., Bradshaw, C.S., et al. “Increasing proportion of herpes simplex virus type 1 among women and men diagnosed with first-episode anogenital herpes: a retrospective observational study over 14 years in Melbourne, Australia.” Sex Transm Infect 95.4 (2019): 307–13. DOI: 10.1136/sextrans-2018-053830. Available from: [https://sti.bmj. com/content/95/4/307.long].
  10. Finger-Jardim, F., Avila, E.C., da Hora, V.P., et al. “Prevalence of herpes simplex virus types 1 and 2 at maternal and fetal sides of the placenta in asymptomatic pregnant women.” Am J Reprod Immunol 78.1 (2017). DOI: 10.1111/aji.12689. Available from: [https://onlinelibrary.wiley.com/doi/10.1111/aji.12689].
  11. Garland, S.M., Steben, M. “Genital herpes.” Best Pract Res Clin Obstet Gynaecol 28.7 (2014): 1098–110. DOI: 10.1016/j. bpobgyn.2014.07.015. Available from: [https://pubmed. ncbi.nlm.nih.gov/25153069].
  12. Wiley Online Library. “Genital Herpes.” J Midwifery Womens Health 58.5 (2013): 597–8. DOI: 10.1111/jmwh.12062. Available from: [https://onlinelibrary.wiley.com/doi/10.1111/jmwh.12062].
  13. Wiley Online Library. “Genital Herpes.” J Midwifery Womens Health 66.6 (2021): 819–20. DOI: 10.1111/jmwh.13325. Available from: [https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13325].
  14. Groves, M.J. “Genital Herpes: A Review.” Am Fam Physician 93.11 (2016): 928–34. Available from: [https://www.aafp.org/pubs/afp/issues/2016/0601/p928.html].
  15. Hammad, W.A.B., Konje, J.C. “Herpes simplex virus infection in pregnancy – An update.” Eur J Obstet Gynecol Reprod Biol 259 (2021): 38–45. DOI: 10.1016/j.ejogrb.2021.01.055. Available from: [https://www.ejog.org/article/S0301-2115(21)00069-5/fulltext].
  16. Johnston, C., Corey, L. “Current Concepts for Genital Herpes Simplex Virus Infection: Diagnostics and Pathogenesis of Genital Tract Shedding.” Clin Microbiol Rev 29.1 (2016): 149–61. DOI: 10.1128/CMR.00043-15. Available from: [https://pubmed.ncbi.nlm.nih.gov/26561565].
  17. Kularatne, R., Venter, J.M.E., Maseko, V., et al. “Etiological Surveillance of Genital Ulcer Syndrome in South Africa: 2019 to 2020.” Sex Transm Dis 49.8 (2022): 571–5. DOI: 10.1097/OLQ.0000000000001645. Available from: [https://journals.lww.com/stdjournal/Abstract/2022/08000/Etiological_Surveillance_of_ Genital_Ulcer_Syndrome.8.aspx].
  18. Le Cleach, L., Trinquart, L., Do, G., et al. “Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients.” Cochrane Database Syst Rev 8 (2014): CD009036. DOI: 10.1002/14651858.CD009036.pub2. Available from: [https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009036.pub2/full].
  19. Legoff, J., Bouhlal, H., Grésenguet, G., et al. “Real-time PCR quantification of genital shedding of herpes simplex virus (HSV) and human immunodeficiency virus (HIV) in women coinfected with HSV and HIV.” J Clin Microbiol 44.2 (2006): 423–32. DOI: 10.1128/JCM.44.2.423-432.2006. Available from: [https://pubmed.ncbi.nlm.nih.gov/16455895].
  20. Leruez-Ville, M., Driessen, M., Pichon, C., et al. “Herpes simplex virus infections during pregnancy: epidemiology, clinical presentation and management.” Virologie (Montrouge) 24.5 (2020): 315–24. DOI: 10.1684/vir.2020.0861. Available from: [https://www.jle.com/fr/revues/vir/edocs/infections_par_ les_virus_herpes_simplex_pendant_la_grossesse_ epidemiologie_aspects_cliniques_et_prise_en_ charge_318786/article.phtml].
  21. Li, D.K., Raebel, M.A., Cheetham, T.C., et al. “Genital herpes and its treatment in relation to preterm delivery.” Am J Epidemiol 180.11 (2014): 1109–17. DOI: 10.1093/aje/kwu242. Available from: [https://academic. oup.com/aje/article/180/11/1109/147904?login=false].
  22. Majewska, A., Mlynarczyk-Bonikowska, B. “40 Years after the Registration of Acyclovir: Do We Need New Anti-Herpetic Drugs?” Int J Mol Sci 23.7 (2022): 3431. DOI: 10.3390/ijms23073431. Available from: [https://pubmed.ncbi.nlm.nih.gov/35408788].
  23. American College of Obstetricians and Gynecologists. “Management of Genital Herpes in Pregnancy: ACOG Practice Bulletinacog Practice Bulletin, Number 220.” Obstet Gynecol 135.5 (2020): e193-e202. DOI: 10.1097/AOG.0000000000003840. Available from: [https://pubmed.ncbi.nlm.nih.gov/32332414].
  24. Matak, M., Matak, L. “Unusual Case Presentation of Genital Herpes.” Acta Dermatovenerol Croat 30.3 (2022): 199–200. Available from: [https://pubmed.ncbi.nlm.nih.gov/36812284/].
  25. Money, D.M., Steben, M. “No. 208-Guidelines for the Management of Herpes Simplex Virus in Pregnancy.” J Obstet Gynaecol Can 39.8 (2017): e199-e205. DOI: 10.1016/j.jogc.2017.04.016. Available from: [https://www.jogc.com/article/S1701-2163(17)30456-5/fulltext].
  26. Nicholson, M., O’Farrell, N. “Genital herpes – diagnosis, treatments, attitudes and response to disclosure amongst members of the UK Herpes Viruses Association.” Int J STD AIDS 32.1 (2021): 23–9. DOI: 10.1177/0956462420951477. Available from: [https://journals.sagepub.com/doi/10.1177/095646242 0951477?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref. org&rfr_dat=cr_pub%20%200pubmed].
  27. Pacheco-Quito, E.M., Bedoya, L.M., Rubio, J., et al. “Layer-by-layer vaginal films for acyclovir controlled release to prevent genital herpes.” Int J Pharm 627 (2022): 122239. DOI: 10.1016/j.ijpharm.2022.122239. Available from: [https://www.sciencedirect.com/science/article/pii/S0378517322007943?via%3Dihub].
  28. Philip, K.E., Goodman, A., Pallawela, S.N., et al. “A not so simplex case of genital herpes.” BMJ Case Rep 2013 (2013): bcr2013009993. DOI: 10.1136/bcr-2013-009993. Available from: [https://casereports.bmj.com/content/2013/bcr-2013-009993.long].
  29. Pinninti, S.G., Kimberlin, D.W. “Maternal and neonatal herpes simplex virus infections.” Am J Perinatol 30.2 (2013): 113–9. DOI: 10.1055/s-0032-1332802. Available from: [https://www. thieme-connect.com/products/ejournals/abstract/10.10 55/s-0032-1332802].
  30. Polansky, H., Javaherian, A., Itzkovitz, E. “Clinical study in genital herpes: natural Gene-Eden-VIR/Novirin versus acyclovir, valacyclovir, and famciclovir.” Drug Des Devel Ther 10 (2016): 2713–22. DOI: 10.2147/DDDT.S112852. Available from: [https://pubmed.ncbi. nlm.nih.gov/27621592].
  31. Ramos, M.C., Sardinha, J.C., Alencar, H.D.R., et al. “Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause genital ulcers.” Rev Soc Bras Med Trop 54 (2021): e2020663. DOI: 10.1590/0037-8682-663-2020. Available from: [https://pubmed.ncbi. nlm.nih.gov/34008730].
  32. Roett, M.A. “Genital Ulcers: Differential Diagnosis and Management.” Am Fam Physician 101.6 (2020): 355–61. Available from: [https://www.aafp.org/pubs/afp/issues/2020/0315/p355.html].
  33. Royer, H.R., Falk, E.C., Heidrich, S.M. “Genital herpes beliefs: implications for sexual health.” J Pediatr Adolesc Gynecol 26.2 (2013): 109–16. DOI: 10.1016/j.jpag.2012.11.007. Available from: [https://www.jpagonline.org/article/S1083-3188(12)00242-2/fulltext].
  34. Sananès, N. “Management of pregnant women with first episode of genital herpes. Guidelines for clinical practice from the French college of gynecologists and obstetricians (CNGOF).” Gynecol Obstet Fertil Senol 45.12 (2017): 664–76. DOI: 10.1016/j.gofs.2017.10.006. Available from: [https://www.sciencedirect.com/science/article/abs/pii/S2468718917302374?via%3Dihub].
  35. Sert, U.Y., Ozgu-Erdinc, A.S., Saygan, S., Engin-Ustun, Y. “Herpes Simplex Infection During Pregnancy, Results of a Tertiary Referral Center in Turkey.” Z Geburtshilfe Neonatol 224.1 (2020): 22–5. DOI: 10.1055/a-0842-6941. Available from: [https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-0842-6941].
  36. Spicknall, I.H., Flagg, E.W., Torrone, E.A. “Estimates of the Prevalence and Incidence of Genital Herpes, United States, 2018.” Sex Transm Dis 48.4 (2021): 260–5. DOI: 10.1097/OLQ.0000000000001375. Available from: [https://journals.lww.com/stdjournal/Fulltext/2021/04000/Estimates_of_the_Prevalence_ and_Incidence_of.9.aspx].
  37. Tuddenham, S., Hamill, M.M., Ghanem, K.G. “Diagnosis and Treatment of Sexually Transmitted Infections: A Review.” JAMA 327.2 (2022): 161–72. DOI: 10.1001/jama.2021.23487. Available from: [https://pubmed.ncbi.nlm.nih.gov/35015033].
  38. Tuokko, H., Bloigu, R., Hukkanen, V. “Herpes simplex virus type 1 genital herpes in young women: current trend in Northern Finland.” Sex Transm Infect 90.2 (2014): 160. DOI: 10.1136/sextrans-2013-051453. Available from: [https://sti.bmj. com/content/90/2/160.long].
  39. Workowski, K.A., Bachmann, L.H., Chan, P.A., et al. “Sexually Transmitted Infections Treatment Guidelines, 2021.” MMWR Recomm Rep 70.4 (2021): 1–187. DOI: 10.15585/mmwr.rr7004a1. Available from: [https://pubmed.ncbi.nlm.nih.gov/34292926].

Downloads

Published

2023-06-30

How to Cite

Markin, L., Matviіenko O., Korytko, O., & Shatylovych, K. (2023). Modern approaches to the therapy of genital herpes in women: Literature review. REPRODUCTIVE ENDOCRINOLOGY, (68), 94–98. https://doi.org/10.18370/2309-4117.2023.68.94-98

Issue

No. 68 (2023)

Section

Infectious diseases

License

Copyright (c) 2023 Л.Б. Маркін, О.О. Матвієнко, О.О. Коритко, К.Л. Шатилович

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.